At this rate every single Abbott government minister is going to get a lump of coal in their Santa stocking.
Liars/SPC “excessively generous”:
- Yahoo7 news: Fact file: Labour costs not to blame for SPC Ardmona’s woes
- Daily Advertiser: Factory closures are on us
- ABC: SPC ‘rite of passage’ for youth
- Brisbane Times: Investigate claims of burns, say voters
- The Australian Financial Review: Voters trust the ABC, says Nielsen poll
- The AgeTwo-thirds of voters believe there should be an inquiry into allegations the Navy deliberately burnt the hands of asylum seekers, a Fairfax-Nielsen poll finds
TPP negotiations secrecy:
Penny Wong in The Australian: TPP deal is not a trophy
Trade Minister Andrew Robb has been complaining about what he describes as “the deliberate peddling of misinformation” on the Trans-Pacific Partnership ( The Australian, Feb 10). He should recall Tony Abbott’s preelection commitment to “restore accountability and improve transparency measures”.
The wholesale ditching of this commitment isn’t just undemocratic — it has real and negative economic consequences.
The “misinformation” the Trade Minister rails against is gaining momentum because of this government’s refusal to be upfront with Australians about its negotiating parameters.
Questions about the potential impact on the Pharmaceutical Benefits Scheme, implications for our copyright regime and the consequences of allowing foreign companies to sue governments for health and environmental reforms are not being answered. Instead, anyone daring to question is attacked and labelled.
In one of his first acts as minister, Robb banished the former government’s trade principles, including transparency, from his department’s website.
Conflicts of Interest:
- Andrew Elder: Catch up Journalism [eta]…make sure you read down to the rant about access journalism vs investigative journalism and the low standards promoted by access journalism[/eta]
- SMH: Staffer Alastair Furnival had links to alcohol industry, helped strip funding from …
- The Age: Fall on your sword, Senator Nash
- The Daily Telegraph: Senator Fiona Nash we want to know what is in our food
BTW, that parliamentary inquiry into the federal government’s commission of audit for commonwealth expenditure that’s being talked up by Abbott et al, and which is looking into the health and welfare sectors this week? They’ve been instructed to only examine expenditure – this government has no interest in examining the revenue side of the budget equation.
What news story/commentary/analysis has grabbed your attention lately?
As usual for media circus threads, please share your bouquets and brickbats for particular items in the mass media, or highlight cogent analysis or pointed twitterstorms etc in new media. Discuss any current sociopolitical issue (the theme of each edition is merely for discussion-starter purposes – all current news items are on topic!).
Categories: economics, ethics & philosophy, media, parties and factions
My favourite at the moment is that the ‘budget blowout’ is largely the result of the ATO paying almost $900 million straight to Murdoch. The biggest kickback in the history of politics, and no one’s even going to get their wrist slapped. This is where your taxes are going, folks. http://www.afr.com/p/business/marketing_media/news_corp_blew_the_budget_DFlluROVi0F6CV1fQ5UJvJ
(Apologies for not embedding link – iPad trickiness)
The comments coming from the ASRC about the issues on Manus are a little different to the spin coming from the Government.
Orlando – well the ATO did lose the court case that they’ve been fighting for a very long time (it occurred back in 1989). So I’m not sure you can really blame the present or even previous government on that. NewsCorp found a hole in the tax legislation (which hopefully has been closed by now!).
Re: TPP – the secrecy is appalling given that we all have to live the consequences of the result. But I think Penny Wong is being rather hypocritical about it all – the ALP were just as secretive about the negotiations when they were in government.
Mindy, I have been devouring anything on these happenings. My partner is a healthcare worker and was due to return to Manus Island today until the situation escalated. He is very concerned about his clients. Tensions had been rising and he had told me that a riot would surely occur any moment. He cannot trust the picture painted by minister Morrisson. Despite accepting the camp and its economic benefits, PNG locals are extremely unhappy with the presence of the asylum seekers, and there are many tensions between PNG police and G4S staff. The ABC video interview with the brother of one of the detainees on Manus was worth watching. With the lights cut and brutal local police response and having histories of enduring war and persecution I would expect that many refugees would flee. I fear that it is actually much more dangerous for them outside the compound.
Chris, the ATO still had a remaining option to appeal, which they didn’t pursue. And while it is the ATO’s call, subject to legal advice, not the government’s, these things are rarely quite so squeaky clean, are they?
Orlando @ 5 – sure, there could be a conspiracy in there, though if legal advice was to appeal and they decided not to under pressure from the minister I’d be kind of surprised if a public servant didn’t leak that. Also given they lost the case if they appealed and then lost again they may well have had to pay even more, and I’d guess in the meantime would have had to adjust the budget estimates anyway.
The deadline to appeal was before the federal election. I’m not sure which minister would have been able to apply pressure in the context of a caretaker government.
Thanks for the link to that wonderful Andrew Elder article.
I agree Hildy, Andrew Elder’s article was brilliant.
This from David Attenborough on Curling.
I haven’t heard, thankfully, any of the commentary on the women’s curling teams from actual commentators. I think I will stick with the Attenborough version.
Although I love John Dwyer, and I think he’s done some great work in public health, surely he can’t be so naive as to think that the Medicare Levy pays for Medicare.
I’m not sure what Drs the Liberal party go to but they seem to have a higher than usual bulk billing rate. They are talking as if everyone is bulk billed and that a $6 co-payment isn’t much to ask. I pay $60 each Drs visit, some of which is refunded via medicare. Are they going to rebate me $6 less? Or will Drs add $6 to their fees?
If this only applies to people who are bulk billed then it will hit pensioners and healthcare card holders, i.e. mainly those who can least afford it for whatever reason they get a pension or a healthcare card.
I get bulk billed for bi-annual pap smears (mostly) and if a skin cancer is removed. If it is a suspicious lump but not cancerous I pay the $60 when the results come in.
So I’m not sure where this idea comes from that no one is paying for Drs visits.
Bulk billing rates are greater than 80%. I get bulk billed when I go to the GP, and I can easily afford not to be – in fact, I prefer to go to a non bulk billing GP but then I get bulk billed sometimes.
Waleed Aly made the good point in the Age today that the brutality meted out to refugees isn’t a policy failure – it’s a policy success. Whatever they are fleeing from, however dreadful, we will make sure they face worse here, so they will not come.
Pretty damn accurate summation of both major parties’ attitude, I thought.
Sometimes the “number of consultations bulk-billed” (80%ish) is spun as if 80% GPs bulk-bills every consultation, which isn’t the case.
What in reality happens is that there are a few fully bulk-billing GPs, though good luck finding one round here, and if you do it’s likely to be a meat factory type practice. Most other GPs I’ve known have a standard fee which has to be significantly higher than the Medicare rebate in order to manage practice costs and cross-subsidise. Then they will choose to discount (often through bulk billing) some particular mixture of other consultations, which might include all or some of: pensioners, people with disabilities, people with a health care card, children, immunisations, certain procedures and followup appointments, colleagues and their families, etc. And since poorer people tend to be in poorer health, and the other discounted appointment types take up a fair chunk of practice time too, that shakes out to around 80%.
I pay full fees at my usual GP (though my child is discounted at his usual GP). I’m cool with the cross-subsidising. I think it’s a damn good idea.
I’m not sure where ‘around here’ is for you, Lauredhel, but in central Sydney it’s easy to find a mix of bulk billing and non bulk billing practices, and not all of the bulk billing practices are meat factories. I don’t know how they make ends meet, but if they can, all power to them.
I’m fine with paying for a cross subsidy if it’s clearly stated at the practice. What I’m not fine with is patients who are wealthier than I am asking me to bulk bill, or the notion that bulk billing _should_ be universal. I feel that, as professionals, doctors should be able to charge what they feel they are worth.
“Around here” is the northern suburbs of Perth, Hildy, and yes fully bulk-billing practices are very few and far between.
The pressure by rich patients to bulk-bill, however, (a pressure that is rather over-stated by doctors, if you ask me) is very much not the focus of the current conversation. Rather, this government is looking to force GPs who choose to discount consultations to the poorest of the poor to instead charge a compulsory co-payment. This is about removing doctors’ choices as well, if you choose to make that the centre of the conversation. However, I’d much rather to look at it more broadly: this is a government that is simultaneously looking to “overhaul” the disability pension (in order to force people off it, despite very poor work prospects for PWD), a government that is setting the stage to undermine the NDIS they supposedly supported, and a government that at the same time is looking to increase the costs of accessing medical care, eroding our current safety net.
As I mentioned above, there are other reasons for doctors to choose to bulk bill a particular consultation. Immunisation is one: done so because it’s valuable public health measure, and removing a financial barrier is one way to improve cover. Another is followup: again, done so because the doctor feels that removing the financial barrier (two gap fees close together) removes an obstacle to that person choosing to forgo necessary followup and continuity of care. These are useful flexibilities in the system.
I agree, and I feel that the freedom to set ones own fees should include the freedom to set them arbitrarily low, or to give completely free care if desired. I bulk bill in my (limited) private practice, but have considered charging a gap. The grumblings I mainly hear from my specialist colleagues whose patients’ GPs bulk bill and thus have requests from their smoking / expensive car driving / iPhone carrying patients to bulk bill.
A reasonable way to improve the access to medical care: more public outpatient clinics, including outpatient GP clinics. Leave the private system alone. Also, no complaining about the 4 hour waits in outpatients.
(I once offered a colleague a private appointment and he chose to come to public outpatients, after which he described the affair as ‘cruel and unusual punishment’.)
The DSP needs to be massively overhauled – not necessarily in the way that the libs envisage, but it’s unworkable in its current state. It forms part of the poverty trap of our current tax&transfer system.
When I lived in Canberra (10 years ago now) there was almost nowhere that would bulk bill patients as a matter of course. They also had a severe GP shortage, mind you. I don’t know that there are many who will bulk bill anyone around suburban or inner city Adelaide either. My doctor is in the CBD and she charges about $70 for a standard consultation at the moment. She bulkbills unemployed/students/pensioners and she bulkbills me sometimes when I’ve just come in for a prescription renewal or an injection.
Hildy: So people deserve to be treated like shit because they have the temerity to be poor and sick at the same time? Yeah, we’re done here.
angharad – my experience in Adelaide (and I know a few GPs) has been that they most often will bulk bill some people. Eg those on health care cards. And also if for some reason you have to go to them a lot over a short period of time they may bulk bill you (happened to me and they just started bulk billing without asking me, then stopped when I wasn’t turning up so often).
I’ve heard a few GPs complain about people turning up in really expensive cars (and not on a healthcare card) and then asking to be bulk billed. Its perhaps not the best criteria, but often its all they have to work with and they use non bulk billed patients to subsidise the ones they do bulk bill. Because apparently the medicare rebate rates just haven’t kept up with the cost of providing the care.
I think the LNP proposal will end up doing two things – pull money from those who can least afford it. And reduce GP incomes. Because although in the short term it might be used as a bit of a price rise, they already charge about as much as they can.
I wouldn’t have a problem with a sliding scale of medicare rebate based on income. With safety nets like we already have if you end up spending a lot of money in a short period on medical care. But its perhaps too expensive and complicated to tie it into the tax system.
Lauredhel: treated like shit? if it’s 3PM and I haven’t had lunch because I’m trying to see all 60 patients in the outpatient clinic alone, I don’t deserve to be abused or even to have complaints directed at me. people are getting good quality care for free. if they don’t like to wait, they can pay for the privilege.
@Chris: Nobody actually knows what the LNP proposal is, so commenting on its potential long term effects appears premature.
So Hildy, Lauredhel’s argument for a well resourced system is nothing more than a slur on you personally? I know you’re tired and overworked but maybe don’t comment on blogs when your brain is fogged. You wouldn’t be so overworked if not for the neoliberal dismantling of the public medical system.
Additionally, people aren’t getting “good quality care” if they’re waiting for hours and their condition deteriorates.
And also. “The freedom to set ones own fees should include the freedom to set them arbitrarily low, or to give completely free care if desired” is fine as far as it goes, but it smacks of the libertarian “rich and poor are equally free to sleep under bridges.”
Lauredhel @13: The pattern appears to be the same here in the inner Western suburbs of Melbourne.
Helen, lauredhel accuse me of treating people like shit when I said that it was acceptable for a four hour wait to be seen in a non-urgent outpatient clinic environment. I think that if your time is worth something to you, then you can spend our money on non-free medical care. I see everyone in a clinically appropriate timeframe, and for some people that timeframe is “can wait for days”.
It isn’t a neoliberal dismantling of the system that leads to that type of overwork; it’s professionalism and caring, such that we don’t cancel appointments simply because one of the two doctors assigned to that clinic is sick. I don’t know what you think extra funding for the health system would achieve in that particular scenario.
As for rich and poor sleeping under bridges: as long as someone has the resources and ability to make choices, who am I to question those choices? I get the impression that Newstart is adequate from the fact that my unemployed patients can afford to smoke a pack a day.
Second datapoint about Melbourne: two weeks ago, I had no problems finding a pleasant GP in suburban Melbourne (south-east) who bulk-billed everyone.
Hildy: As someone who has worked for years/decades both in hospitals and in general practice, and been closely involved in setting up hospital-general practice partnerships, including the economics of same, I put it to you that (a) if we could do general practice more efficiently in hospital outpatients, we would have done it by now; (b) good quality community care absolutely does not involve having infectious, acutely sick, disabled, elderly, and chronically ill people (noting also that those conditions aren’t mutually exclusive) travelling distances by public transport and then sitting together in cramped uncomfortable conditions for many hours; (c) you haven’t given the first thought about how you’re going to staff these proposed public mega-clinics with experienced GPs (hint: you can’t, and second hint: hospital residents cannot provide good GP care); (d) our current community general practice system provides good care for the money in cities and suburbs at the moment, needing only quite small tweaks (and larger tweaks rurally); and (e) that you currently have absolutely no fucking idea what you’re talking about, except from your own very narrow perspective, and you need to get out in the world a bit more before deciding that you know everything about everything.
I’m not claiming any of the things that you are imputing to me. I’m saying that:
– you cannot control costs in a fee for service with no copayment environment
– salaried (rather than FFS) practitioners are an effective means of cost control (compare VMOs vs staff specialists)
– if salaried hospital registrars are deemed good enough to operate on and care for patients, why are salaried GP registrars not good enough? in addition, hospital residents are already going into the community (in their second postgraduate year) and working as semi-supervised general practitioners.
– why should indigent patients get choice of practitioner, being seen by the specialist rather than the trainee, etc?
Our current system is broken because of cost shifting between state governments who provide hospital care and some community, and the federal government which pays for some community care. I don’t know where or when you last worked, but in NSW, the cost shifting is obvious, especially in the areas of pharmaceuticals and dressings, and patients fall through the cracks all the time.